Study finds increase in retail co-pays for prescription drugs

PLANO, Texas — Retail co-pays for drugs are on the rise across all drug types, according to a new study by the Pharmacy Benefit Management Institute.

The study, based on a survey of 424 U.S. employers representing about 3.7 million members, found that retail co-pays increased 10% for generics, 13% for branded drugs and 26% for specialty drugs. Meanwhile, there was an increase in use of multitier designs, which now represent 92% of plan sponsors, while adoption of medication therapy management for commercial populations was "minimal."

"Readers of this report can expect to see all of the survey results broken out by larger and smaller employers, a new change for this year," PBMI executive director Brenda Motheral said. "This report is the only industry report that captures data provided by plan sponsors about their pharmacy discount rates; and this year, we had a record number of plan sponsors sharing details about their pharmacy reimbursement and rebate amounts."

The differential gap between tiers continued to grow, as the average differential between generic and preferred brand co-pays was $19, compared to $7 in 2007. The average differential between preferred and nonpreferred co-pays was $23, compared with $13 in 2007.

Symposium brings together specialty pharmacy stakeholders

PHILADELPHIA — The changing healthcare environment and the challenges and opportunities of specialty pharmacy were the biggest themes at Acro Pharmaceutical Services’ sixth annual Payer and Managed Care Symposium in Philadelphia last Thursday.

Representatives from drug makers and across the specialty pharmacy space met at the Hyatt at the Bellevue to discuss a wide variety of topics related to specialty pharmacy.

Following opening remarks by Acro president Sajid Syed, Philadelphia-based Independence Blue Cross SVP and chief medical officer Richard Snyder took the stage to talk about the shift to accountable care and its effects on payer and provider relations.

Afterward, Gorman Health Group chairman John Gorman provided the view from Washington, talking about such topics as the election and its implications for government health programs and Medicare.

"We’ve got to all collaborate to deliver better value to the member, the payer and ultimately to the customer, the federal government," Gorman said. The implications of healthcare reform were huge, he said.

"We are on a lightning path toward the biggest reform of our health system we’ve seen maybe since Medicare and Medicaid," he said.

Accountable care organizations are set to "explode," he said, predicting a leap forward in the health system that he compared to Turkey’s sudden embrace of mobile phones in the 1990s that skipped the development of land lines. Healthcare delivery could become similar to public utilities: heavily regulated, with mandated expense margins and a need for organizations to provide unique value as middlemen or else "you’re toast."

Gorman also spoke of dual eligibles — people who are eligible for Medicare savings programs or Medicaid benefits. They are an important group for specialty, he said, and will be in need of services like medication therapy management.

Following Gorman’s presentation, Specialty Pharmacy Solutions founder Bill Sullivan briefly talked about trends in the drug pipeline and biosimilars, noting that specialty made up about 20% of drug spend in 2010, totaling $100 billion, despite accounting for only 1% of the population. Today, that figure is 25%, expected to reach 40% by 2015, while specialty drugs represent about 50% of the drug-development pipeline.

Afterward, PerformRx president Mesfin Tegenu spoke about topics like the budget crisis and what high-priced specialty drugs could add to it. "I don’t think anyone understands what to do when a drug comes out with a $100,000 cost and extends a cancer patient’s life by three months," Tegenu said.

Following a brief introduction to the National Association of Specialty Pharmacy by president Gary Cohen, University of the Sciences president emeritus Philip Gerbino moderated a panel discussion that included representatives from several payers who discussed topics like the value of specialty drugs and the need to manage coverage and opportunities and challenges from the Patient Protection and Affordable Care Act.

"We need pharma to come up and show us the value of some of these therapies," Syed told Drug Store News. "We want to hear how pharma is showing value and openign access to pharmacies so the patient gets the right drug at the right time."

TORONTO — Customer service is the key driver of brand advocacy in retail pharmacy, according to a new study.

Customer experience management firm Empathica released results of a survey of more than 1,500 consumers, polling customers on their perception, attitude and opinion toward the retail pharmacy experience. Across brands, three main factors — choice, service and trust — drove brand advocacy. Of the top six pharmacy retailers in terms of market share — Costco, CVS, Kroger, Rite Aid, Walgreens and Walmart — Kroger received top marks in nearly all customer service categories, with 4-in-5 Kroger customers agreeing or strongly agreeing that they would recommend it to friends and family.

"Retail pharmacies can create a win-win relationship with customers by providing exemplary customer service; in turn, there is an opportunity for customers to ‘work’ for their primary pharmacy as brand advocates," Empathica CEO Gary Edwards said. "There is little room for winning a price war in pharmacy retail. The real battlefront for pharmacies is in customer service and convenience."

The study also found differences in how drug store chains and mass merchandise chains and supermarkets promote their business and how they can learn from each other. For example, only one-third of mass-retail customers indicated they were aware of loyalty programs, compared with 43% of drug store customers. Meanwhile, drug store chains could look to mass retailers for how to provide in-store promotions; 32% of drug store customers answered that they "always" found attractively priced promotions, compared with 44% of mass retail customers.

"To build a stronger, more loyal customer base, mass retailers and specialty drug chain retailers can look to what the other has to offer," Edwards said. "Rather than focusing exclusively on general customer service or in-store promotions, all pharmacy retailers have an opportunity to better manage the key moments of truth on the customer journey. This includes providing more choices, offering superior service throughout the experience and promoting loyalty programs to create deeper relationships with customers. When customers experience exceptionality in these areas, regardless of price, it definitely builds brand advocacy."

As part of a panel at the recent Drug Store News Industry Issues Summit, officials from Walmart and Kroger shared the ways the two organizations go about taking a collaborative approach to health care.

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